Delving into the Management of COVID-19 in Malaysia: A Case Series during the Second Wave of the Pandemic

Introduction: Malaysia announced its first COVID-19 infection on 25 January 2020, involving three China tourists from Singapore who entered Malaysia via Johor. This was a retrospective case series describing the management of patients with confirmed COVID-19 infections during the early waves in one of the states in Malaysia. Methods: A total of 12 adult confirmed cases of COVID-19 requiring hospital admission were identified from March to May 2020. At least 1 case was reported for each clinical stage. Cases were retrospectively reviewed through electronic medical records from the first COVID-19 contact until hospital discharge. Relevant study endpoints such as clinical presentations, patients' outcomes, treatment given during hospitalization, and related laboratory data were noted. Results: All 12 patients were of Malay ethnicity, with cases equally distributed across both genders. The mean (SD) age of the study population was 52.0 (15.3) years old, with 2 of them being geriatric patients. Symptomatic cases with clinical stage 2 and above received pharmacological treatment, such as hydroxychloroquine, lopinavir/ritonavir, interferon, and tocilizumab. Adverse drug reactions due to lopinavir/ritonavir were reported in 2 patients. Among laboratory tests conducted were absolute lymphocyte count, C-reactive protein, ferritin, lactate dehydrogenase, D-dimer, and procalcitonin. All but one patient managed to recover from the infection. Conclusions: Early on in the pandemic, hydroxychloroquine and lopinavir/ritonavir were among the suggested medications for COVID-19. As new evidence emerges, the search for specific treatment continues with only corticosteroids have been proven effective in the severe and critical stage of the infection